Agenda item

To receive a report from the Hampshire and Isle of Wight (HIOW) Sustainability and Transformation Partnership (STP) Task and Finish Working Group and an update from the HIOW STP on the process and progress in developing an NHS Long Term Strategic Delivery Plan for Hampshire and the Isle of Wight.

Representatives from the Hampshire and Isle of Wight (HIOW) Sustainability and Transformation Partnership (STP) provided an update on the process and progress in developing an NHS Long Term Strategic Delivery Plan for Hampshire and the Isle of Wight, alongside a report from the HIOW STP Task and Finish Working Group.

Members heard:

• Based on the NHS long term plan blueprint for 10 years, a collaborative plan for implementation of expectations are to be submitted 15 November. 
• The current work entails a response for 496 commitments laid out, refining strategy to planned implementation with the greatest value for citizens. 
• While there is some discretion over timing, each item requires implementation.
• Existing engagement work and building on the work of HWBs to meet population needs with a proactive integrated care program in the community and collaboration of social care colleagues. 
• Treating patients seamlessly in the right place at the right time while fostering a culture and behaviour change where the patient can easily access multiple services, accounting for cultural, technology, and competency challenges. 
• Population health management, critical NHS changes and better using capital, digital, workforce resources for networked care and implementation of the direction of travel with a new model of health and care. 
• Working together across providers (addressing workforce and specialization challenges) for 24-7 services to balance capacity and anticipated demand. 
• Promoting learning from each other and implementing safe, sustainable changes by building relationships and collaboration with larger, effective providers.
• Lack of access can cause a period of fragmentation of health.
• Capacity insights are largely unknown but must be understood to mobilize a more rapid response.
• A live capacity and demand model would help manage mismatches and address them with agile responses.
• Digitalizing outpatient activity would save time and transportation costs.
• Coordinated visits would allow for multiple concerns to be addressed in one go.
• Transforming access is a massive issue and focus, including managing mental health out of area beds and collaboration across all services to use bed stock.
• Focus on prevention and managing an aging demographic – live well, age well, live with, rather than suffer with, and a radical approach to prevent ill health.
• STP learning through prevention agenda, considering existing data, shared information, and especially public health collaboration for prevention of pregnant women smoking, new-born care, addressing adverse physical events, care in the right setting, promoting exercise, living well, child reporting, etc.
• Half a billion pounds marked for transformation over the next 5 years but the STP must deliver and spend to improve experiences and focused improvements. 
• Workforce remains the most significant challenge for health and care partners. 
• Better leadership and a strong recruitment position will help establish Hampshire and the Isle of Wight as an attractive place to work and key to working well.
• A bank to allow staff to move seamlessly across positions with dynamic solutions and improved technology at all levels (artificial intelligence, electronic medical records, etc.) will drive efficiency and productivity.
• Well placed digital solutions, cost suppression and thoughtful deployment are profoundly important for scaling and porting for better decisions and outcomes.
• Moving from a competitive environment to an improved, shared service by scaling by leveraging advantages with the largest employers and groups. 

In response to questions, Members heard:

• A project management plan with resources, timescales, milestones, and investment trajectories are critical for inclusion in the final submission.
• A 2-year timeline is manageable but past that, trajectories will need revisiting.
• A realistic finance and workforce plan for the 496 required goals alongside targets and metrics for health and care will be included.
• All documentation will be shared on the websites of all statutory organizations.
• Organizational and governance structure for implementation will also be shared.
• Current draft plans include 200 pages of appendices but not yet a coherent plan.
• Forensic and thorough feedback received will guide the final development of the plan and it will be submitted to the HASC for consideration.
• By April 2021 the HIOW STP will need to evolve into an Integrated Care System with delegated responsibility from NHS Health and Social Care and feedback from NHS England and NHS Improvements.
• Being a large county with many partners, CCG legacies, and local authority footprints, strong commitments must be made in November to work together.
• A report with a traffic light system against each of the items and the current status will be compiled and shared by the partnership board overseeing the implementation of the long-term plan including actions, risks, and progress. 
• The STP will engage with health partners, acute trusts, HCC, voluntary sector, and NHS to focus on a seamless prevention plan.
• The collaboration will mirror the work of the HWB and be part of a wider plan alongside district and borough partners for the work to move forwards. 
• The Executive Member for Public Health’s commitment to lead on prevention and identifying the critical path to deploy resources for the best outcomes.
• A collective commitment is central to prevention programs being at the heart of all that is done and the core philosophy of providers (community or specialist).
• Clinical Directors of the PCNs have statutory responsibility to provide better local care and effective use of health and social care assets and capital.
• Executive responsibility for direction lies with Maggie MacIsaac - the senior officer with supportive officers being accountable to the partnership board.
• This will be the largest transformation of health and care and PCNs are vital investments to overcome the historical model of fragmented leadership.
• An example of a positive STP outcome is that children’s care hubs have had the largest reduction in antibiotics prescribed in the country.
• Consistent use of prevention and monitoring technology in surgeries and primary care is critical to equity in care. 
• Improvements to the model of care and facilitated collaboration on quality improvement with all partners will achieve results across various footprints.
• Technology and digital updates will allow the improvement of care at the point of service, but usage maintenance is equally vital through the use of behavioural science for better, consistent habits for health management.
• The Joint Strategic Needs Assessment (JSNA) has been broadened to include Hampshire and Isle of Wight for best use of  shared resources for a radical and flexible approach for prevention of ill health and manage future demand systematically with the NHS. 
• The HCC commitment for participating in the STP process and the NHS long term plan with 496 items and 65 performance metrics – clinical outcomes and indicators with 500 thousand of the funds linked to NHS delivered services. 
• The long-term plan seeks to put into place the right things to do and social prescribing, but it is important to consider what is already being done.
• Elements include only new PCN activity, but not necessarily existing services and infrastructure and local implementation or delivery. 
• The HCC is keen to see STP/ICS deliver what is needed for the Hampshire population and engaging as a partner, rather than a stakeholder.
• Social care alongside prevention are critical to health outcomes and goals.

RESOLVED

That the Committee:

1. Noted the priority areas identified by the HIOW Long Term Plan and the new service model which is currently in development.
2. Will continue to monitor the progress of the HIOW Long Term Plan as necessary either via updates from the Working Group or by inviting the STP teams to present directly to the HASC.
3. Requests the release of the 15 November paper submission to the HASC for review.